Healthcare Innovation' is quite the buzzword lately. Between Todd
Park encouraging innovation in health IT by opening a government data API and
the mHealth app market set to triple by 2012, it's staggering how quickly
technology in the industry is advancing.
We'd like to take this opportunity to highlight one stakeholder
group that is rapidly innovating to overcome today's challenges: health plans.
By using web-based tools to connect with and service physicians and granting
patients access to information through mobile apps, there are many
organizations that we are proud to work alongside as our industry continues to
evolve.There is no doubt that health plans are an integral piece in the care
delivery puzzle. Louis
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As Dave Kerrigan suggested in his blog post The Payor (R )evolution,
payers are in the driver's seat for disruptive innovations. One of the greatest
sources of inefficiencies in our healthcare system is around financial
transparency and expediency of reimbursements. Unknown financial and clinical
variables in the care process put patients and physicians at risk for high
bills and low reimbursement. Advances in revenue cycle management lead by
leading health plans such as Aetna are
changing that. Aetna built a solid system of communication, a process for which
they were recognized in the 2011 PayerView Rankings, which evaluated data from
132 national, regional and government payers in the US in efficiency, clarity and
effectiveness of their client transactions. Aetna
was noted for their ability to engage with doctors thanks to simplifying key
business and financial operations. They scored a spot in the top percent of
health plans able to resolve claims upon submission, clear and accessible
policies that resulted in low denial rates and electronic remittance advice
transparency.
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change into focus. Aetna 's ability to educate
physicians around what medical expenses the plan will cover is crucial to
driving down the cost, frustration and anxiety within this industry.
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